Attack of the Hormone Replacement Purveyors (Part 3)

When women were first talked into taking lots of hormone replacement therapy, way back in the 1960s, the main reason was probably that woman-hater of a book that was titled, “Feminine Forever”, and claimed that women aren’t complete human beings unless they keep their sex hormones high enough to look, and be, fertile until the end of their lives.  Secretly, I’ll bet women usually have hormone replacement therapy today for the same reasons they had it back then.  1) They’re either having terrible menopausal symptoms, or 2) They think they look better if they have higher estrogen and progestin levels.  Now, I don’t know the incidence of either of these problems because I don’t go around asking my women friends if they’re full of menopause symptoms or if they take hormone therapy to improve their looks.  I’ll bet there are plenty of women who take hormones and still look awful.  And there are plenty of women who don’t, and they still look great.  I just don’t know exactly.

But I do know how doctors justified giving women extra hormones, back in the 1960s.  They told the women, and themselves, that the hormones reduced women’s risk of heart attacks.

We’ll dismantle that idea ruthlessly in just another minute.  But first, it may be instructive to look at how the dummies (and I am referring to the doctors, here) rationalized to themselves that extra hormones would reduce female heart attacks.

So here we go.

The reasoning of the medical profession in favor of promoting the “health benefits” of hormone therapy went like this:  As a woman enters her 40s and 50s, her estrogen levels fall, and at some point her menstrual cycles end.  Many women suffer painful symptoms during this transition.  What’s more, the end of menopause marks the end of a protective period regarding heart attacks.  You see, while women still have monthly periods, they’re far less prone to heart disease than are men their age.  But once those monthly cycles end, a woman’s risk of heart attacks rises, until it’s equal to the risk for men.

Because estrogen levels go down at the same time as a woman’s risk of heart attacks goes up, it seemed logical to the medical community that lower estrogen levels caused heart attacks.  The medical community thought that hormone replacement would solve the heart attack risk while it also got rid of other nasty things such as hot flashes, loss of sex drive, horrible headaches, exhaustion and so on – the menopausal symptoms that plague so many women who eat a standard Western Diet.  So for one pill, you’d get two good outcomes at once.  An immensely profitable industry arose to take estrogen from the urine of pregnant mares, transform it into Premarin, and then sell the pills to menopausal women.

So, before we go on, you might as well know that by recommending hormone supplementation, the medical community had gone galloping off in completely the wrong direction.  We’ll skip to the punch line and then come back.  You see, to reduce women’s heart attack risk, they would have done more good by asking menopausal women to head over to the Red Cross more often and donate more blood.  That’s because, once menopause ends a woman’s monthly bleeding cycles, her iron levels start to rise until they’re equivalent to men’s.  Now, in many people, iron levels don’t ever rise too high.  But occasionally, in men throughout their lives and in menopausal women after their periods stop, iron levels can rise to a hazardous range, which leads the iron to oxidize things.  You know how, if you’ve got rust in your car engine (or at least, so I’ve been told), it can make everything operate more sluggishly, and it can even damage the engine?  Well, oxidation of excess iron in your body, or rust, can also damage your blood vessels. And Voila!  You’ve got the increase in heart attack risk.

A fellow like our friend, the maverick doctor, would be more likely to spot this for two reasons.  One is that he cares about energy efficiency, and no one who likes energy efficiency is going to have much patience for things that cause rust.  That attitude would make him more likely to look for problems caused by higher iron levels.

As for the hormone levels that go down after menopause, when it comes to heart attack risk, he would have presumed that this concern was a total red herring.  That’s because in laboratory animals, if you take out their sex organs, they live longer.  Now, no, I’m not recommending that for human beings.  So let’s be glad we can learn something from these mean experiments, without having to do it all on us.  The point to learn is that reducing the activity of sex hormones seems to help a body do more to maintain itself, which leads to a longer life.  And there’s more logic to it than even this.  Bodies can either be leaning towards reproduction, or they can be leaning towards maintenance and repair on the cellular level.  Since there are always limited resources, when a body is primed for reproduction, it doesn’t have as much time or resources for maintenance.  Hmm.  I guess an analogy would be, if you were spending lots of money to look good and dress up for a really hot date, that’s not a time when you’re SAVING money.  But whatever would be a better analogy, you get the idea.  Put your chips in the reproductive account, and you’ve got less left over for the maintenance and repair account.

So that’s the basic tradeoff in our bodies, even though it’s not how those medical nincompoops were thinking back then.

And here are a few more things they weren’t thinking about:

First is the fact that among women throughout the world who don’t eat the typical American diet, menopausal symptoms are uncommon, including the increased risk for heart attacks.  Second, as we sort of hinted at with the castrated rats, the fact that as a woman ages there’s a decline of her reproductive hormones suggests that such changes might be to protect her health and even the survival of her extended family.  There are some obvious reasons that fertility might be a bad idea in an older women, such as that an older mother is more likely to bear a baby with a birth defect.  That’s a bad evolutionary strategy—to have more babies born with birth defects.  Along those same lines, an older women is likely to have more stress during pregnancy, and is more likely to be injured or die in childbirth, leaving an entire family without a mom—another bad evolutionary strategy.

And to top it all off, this tragedy would leave the whole village without a useful woman of that venerable grandmother age.  Throughout time, grandmothers really have been special.  There are studies by evolutionary scientists that indicate that in a community where grandmothers are present, grandchildren are more likely to survive.  We can extrapolate from this to say that having healthy, experienced, older women is so valuable to a community, that it’s more valuable than risking their lives to have yet another baby.

But to wrestle with the GONAD FAILURE folks, we’ve got to build an even stronger argument.  I can hear them out there, running toward the ring, waving their packs of bioidentical hormones and shouting, “So take birth control, and also, take our pills!  Take birth control AND take our pills!!!”

But as a woman gets older, I don’t think that eliminating the risk of bearing a baby is the only reason our reproductive hormones finally go down.  If it’s truly of value to have experienced older woman survive to contribute their wisdom and skills to the whole community, then I wonder whether the decline of reproductive hormones in older women is simply to reduce her body’s global wear and tear.  You see, even when a woman isn’t pregnant, reproductive hormones such as estrogen send out signals for every cell in the body to speed things up – to be poised for being fruitful and multiplying.  A body has to be on its toes to handle cells that multiply fast.  It has to have plenty of repair crews at the ready in case there’s something such as a sudden mutation—read that as cancer or inflammation–which in turn can lead to stuff like full-blown cancer and heart attacks.  The likelihood of keeping an aging body healthy and long-lived is probably better when a woman’s hormone levels stay low.

So when women took Premarin, or if they take the bioidentical stuff, then they’re sort of trying to do an end-run around what may be a very wise survival strategy of our bodies, hormonal-wise.  Just when we want to have more room for maintenance and repair of our bodies, we’ll force them to stay whipped up for action by supplementing our hormone levels.  It’s likely that this really won’t be so good.

If the notion of gonadal failure and bioidentical hormones ever take off, will we ever know if they’re causing more cancer and heart attacks?  I doubt it.  It was a huge study that led to the discovery that hormones in drugs such as Premarin caused more cancer and heart attacks.  It took a lot of time and a lot of money, and that kind of study probably won’t be done for something like an over-the-counter supplement.  So IF it causes more deaths, the women it kills can probably remain in ignorance about it.

There are just two more things to say.  First, why do women have to get all the menopause and hot flashes and other symptoms?  Why doesn’t this happen to men?

Well, the answer’s probably that it’s more energy expensive to maintain a woman’s reproductive system than it is to maintain a man’s.  So to help women survive longer, it makes more sense to switch off their reproductive capabilities in their later years.  And, interestingly enough, women DO tend to live longer than men do.  Could it partly be because they’ve gone through menopause?  I wonder.

Now here’s the last, last thing.  About those awful menopausal symptoms.  I asked a chiropractor friend about them, and he said something that surprised me quite a bit at first.  “Menopausal symptoms?” he said.  “Then those women should have their adrenals checked.”

I started to turn to him and give him a lecture about anatomy.  “No, no,” I was ready to say.  “The adrenals and the ovaries are two different things.”  But, in a nick of time, I decided that maybe, in addition to knowing his left foot from his right, he might know the rest of human anatomy.  So I let him keep talking.

“You see,” this holistic doctor said, “after a woman’s menopause, when the ovary production of hormones has declined, there are still sex hormones being produced, but it’s a job that’s done at a much lower level of output, through organs such as the adrenal glands.  But if a woman’s stressed, and her adrenals are burned out, then she’s going to have a lot of menopause systems.  At least that’s been my experience.”

So ladies, less stress, anyone?  And how about checking those adrenals.

And gonadal failure people, please, please, stay away.